Tesis

Sindrom pasca COVID-19 pada Lansia dan Faktor-Faktor Risikonya = Post COVID-19 Syndrome in Older Adults and The Risk Factors : A multicenter study.

Latar belakang: COVID-19 menginfeksi semua kelompok umur, namun kendati demikian beban infeksi lebih tinggi dan lebih berbahaya pada kelompok lanjut usia. Pasien yang mengalami infeksi akut COVID-19 juga bisa mengalami gejala menetap yang disebut dengan Sindrom pasca COVID-19, khususnya pasien lansia yang memiliki tingkat morbiditas dan mortalitas yang tinggi. Belum ada data yang menunjukkan prevalensi Sindrom pasca COVID-19 pada lansia di Indonesia dan juga faktor-faktor risiko yang berhubungan dengan kejadian Sindrom pasca COVID-19 pada lansia. Tujuan: Penelitian ini bertujuan untuk mengetahui seberapa besar prevalensi Sindrom pasca COVID-19 pada lansia di Indonesia serta meneliti hubungan antara faktor-faktor risiko dengan kejadian Sindrom pasca COVID-19 dengan menggunakan definisi waktu > 4 minggu, >8 minggu, dan > 12 minggu. Metode: Penelitian ini merupakan penelitian kohort retrospektif yang menggunakan rekam medis dan wawancara untuk mendapatkan data terkait keberadaan faktor-faktor risiko dan gejala menetap pasca perawatan infeksi akut COVID-19. Hasil: Penelitian ini diikuti oleh 329 pasien lansia ( ≥ 60 tahun) yang sempat dirawat akibat COVID-19 di Rumah Sakit Cipto Mangunkusumo dan Rumah Sakit Mitra Keluarga Kalideres selama periode 1 Januari-31 Desember 2021. Penelitian ini menemukan prevalensi Sindrom pasca COVID-19 pada lansia adalah sebesar 31%, 18,24%, dan 10,64% dengan menggunakan definisi waktu > 4 minggu, > 8 minggu, dan > 12 minggu, secara berurutan. Hasil analisis multivariat menunjukkan nilai Clinical Frailty Scale rawat inap (OR 2,814 [IK 95% 1,172-6,758) dan imobilitas rawat inap (OR 4,767 [IK95% 2,117-10,734]) berhubungan dengan Sindrom pasca COVID-19 > 4 minggu. Selanjutnya, jumlah gejala awal (OR 2,043 [IK95% 1,005- 4,153]), konstipasi rawat inap (OR 2,832 [IK95% 1,209-6,633]), imobilitas rawat inap (OR 2,515 [IK95% 1,049-6,026]), dan instabilitas rawat inap (OR 2,291 [IK95% 1,094-4,800) berhubungan dengan Sindrom pasca COVID-19 > 8 minggu. Selain itu, gangguan pendengaran dan penglihatan follow-up (OR 2,926 [IK95% 1,285-6,665]) dan imobilitas rawat inap (OR 3,684 [IK95% 1,507-9,009]) berhubungan dengan Sindrom pasca COVID-19 > 12 minggu. Kesimpulan: Peneliti menarik kesimpulan bahwa infeksi akut dengan ≥ 5 gejala, adanya frailty dan sindrom geriatri, khususnya imobilitas pada saat perawatan, berhubungan dengan kejadian Sindrom pasca COVID-19 pada lansia.
Kata kunci: Sindrom pasca COVID-19, lansia, faktor risiko



Background: COVID-19 infects all age groups, but the burden of infection is higher and more dangerous in the elderly. Patients with acute COVID-19 infection can also experience persistent symptoms called Post-Covid-19 Syndrome, especially elderly patients with high morbidity and mortality rates. No data show the prevalence of Post-Covid-19 Syndrome in the elderly in Indonesia and also the risk factors associated with the occurrence of Post-Covid-19 Syndrome in the elderly. Objective: This study aims to determine the prevalence of Post-Covid-19 Syndrome in the elderly in Indonesia and examine the relationship between risk factors and the incidence of Post-Covid-19 Syndrome by using the definition of time > 4 weeks, > 8 weeks. , and > 12 weeks. Methods: This study is a retrospective cohort study that uses medical records and interviews to obtain data regarding risk factors and persistent symptoms after treatment of acute COVID-19 infection. Results: This study is followed by 329 elderly patients (≥ 60 years) who had been treated because of COVID-19 at Cipto Mangunkusumo Hospital and Mitra Keluarga Kalideres Hospital from January 1st until December 31st, 2021. This study showed that the prevalence of Post COVID-19 Syndrome in the elderly was 31%, 18.24%, and 10.64% using the time definition of > 4 weeks, > 8 weeks, and > 12 weeks, respectively. The results of multivariate analysis showed that the Clinical Frailty Scale during hospitalization scores (OR 2.814 [95% CI 1.1 72- 6.758]) and immobility during hospitalization (OR 4.767 [95% CI 2.117-10.734]) were associated with Post-Covid-19 Syndrome > 4 weeks. Furthermore, number of initial symptoms (OR 2,043 [CI95% 1.005-4.153]), constipation during hospitalization (OR 2.832 [CI95% 1.209-6633]), immobility during hospitalization (OR 2,515 [95% CI 1,049-6.026]), and instability during hospitalization (OR 2,291 [CI 95% 1,094-4,800]) was associated with Post-Covid-19 Syndrome > 8 weeks. In addition, impairment of visual and hearing during follow-up (OR 2,926 [95% CI 1,285-6,665]) and immobility during hospitalization (OR 3,684 [95% CI 1.507- 9,009]) was associated with Post-Covid-19 Syndrome > 12 weeks. Conclusions: The researcher concluded that acute infection with ≥ 5 symptoms, frailty, and geriatric syndrome, especially immobility during hospitalization, were associated with Post-Covid-19 Syndrome in the elderly.
Keywords: Post COVID-19 Syndrome, older adult, risk factor